Ewha Med J EMJ The Ewha Medical Journal 2234-3180 2234-2591 Ewha Womans University School of Medicine 10.12771/emj.2012.35.1.49 Case Report A Case of Ileal Mesenteric Desmoid Tumor Resected by Laparoscopic Surgery Noh Kyoung Tae Sung Sun Hee 1 Lee Ryung-Ah Department of Surgery, Ewha Womans University School of Medicine, Seoul, Korea. Department of Pathology, Ewha Womans University School of Medicine, Seoul, Korea. Corresponding author: Ryung-Ah Lee, Department of Surgery, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 158-710, Korea. Tel: 82-2-2650-2659, Fax: 82-2-2644-7984, ralee@ewha.ac.kr 03 2012 31 03 2012 35 1 49 53 23 08 2011 28 10 2011 Copyright © 2012. Ewha Womans University School of Medicine 2012

Desmoid tumor is rare neoplasm originated from fibrous sheath or musculoaponeurotic structure. It is classified as benign tumor histologically, but clinically, it has malignant characteristics due to its infiltrative growth to adjacent organ and frequent local recurrence. Especially, mesenteric desmoid tumor shows poor prognosis because of its symptoms of pain, intestinal obstruction, ureter obstruction and fistula formation and high frequency of recurrence. We experienced a case of mesenteric desmoid tumor in a 64-year-old woman with a painless abdominal mass. Laparoscopic exploration was performed and 10 cm sized mesenteric mass was identified, which resected widely and the diagnosis was confirmed with desmoid tumor by pathologic report. We reviewed the feature of the mesenteric desmoid tumor, that is, pathophysiology, clinical presentations, diagnosis, treatment and prognosis.

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Abdominal CT findings. 10×6.5 cm sized solid mass is visible in right lower quadrant. The tumor originates from small bowel mesentery. (A) Horizontal view. (B) Coronal view.

Gross pathologic finding. 9.5×9×5 cm sized well demarcated mass is identified in the small bowel mesentery. Retraction diverticulum is visible on ileal mucosa.

Micropathologic finding. (A) The tumor infiltrates into the muscle layers of small bowel (H&E stain, ×40). (B) Fibroblastic spindle cells are arranged orderly in collagenous or myxoid matrix (H&E stain, ×100).

Immunohistochemical stain for β-catenin shows nuclear and cytoplasmic positivity in tumor cells (Immunohistochemical stain, ×400).